New review maps advances in coronary intravascular imaging and computational methods to support safer, personalized percutaneous coronary intervention for heart disease patients

A comprehensive review published in Cardiology Discovery outlines recent technical and computational improvements to coronary intravascular imaging that could help interventional cardiologists better characterize coronary lesions, identify high-risk plaques, and improve outcomes for patients living with coronary artery disease. The work summarizes peer‑reviewed evidence spanning January 2015 through June 2025, covering well‑established and newly developed imaging platforms together with artificial‑intelligence and biomechanical‑modelling approaches for percutaneous coronary intervention guidance.

Coronary artery disease continues to rank as the leading source of global morbidity and mortality. Conventional coronary angiography, long‑used to plan stenting procedures, only produces a two‑dimensional outline of the artery lumen and cannot reveal underlying plaque pathology. Intravascular imaging addresses this gap, yet each individual imaging modality carries inherent trade‑offs in resolution, tissue penetration, or need for blood clearance, limiting standalone performance in complex patient cases.

Researchers analyzed human investigations, clinical trials, consensus guidelines and select pre‑clinical work focused on intravascular ultrasound, optical coherence tomography, near‑infrared spectroscopy and newer molecular‑imaging techniques. Investigators also evaluated computational workflows including artificial‑intelligence image processing, computational physiology and plaque biomechanical stress assessment.

The review notes hybrid intravascular ultrasound‑optical coherence tomography and optical coherence tomography‑fluorescence‑lifetime‑imaging catheters have reached first‑in‑human evaluation. Artificial‑intelligence‑driven plaque characterization achieves diagnostic performance comparable to expert human readers. Computational‑physiology algorithms permit functional stenosis evaluation derived from a single intravascular imaging pullback, supporting unified anatomical, compositional and functional coronary lesion assessment.

Important limitations temper near‑term widespread adoption. This is a narrative review rather than original clinical research, so it cannot perform formal head‑to‑head statistical comparison across imaging platforms. Multiple emerging modalities remain at early‑phase clinical or pre‑clinical stages. Real‑world deployment requires standardized validation protocols, larger multicenter trials, and smoother integration into busy interventional laboratory workflows. Future development will focus on lowering system costs, reducing catheter size and building trustworthy, interpretable artificial‑intelligence tools for real‑time procedural support.

Article citation: Tan Q, Hou X, Yang F, et al. Recent Advances in Coronary Intravascular Imaging and Computational Methods. Cardiology Discovery. DOI: 10.1097/CD9.0000000000000211